Clinical variables associated with the presence of articular pain in patients with temporomandibular joint clicking

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ORIGINAL ARTICLE

Clinical variables associated with the presence of articular pain in patients with temporomandibular joint clicking Rodrigo Lorenzi Poluha 1 & Giancarlo De la Torre Canales 1 & Leonardo Rigoldi Bonjardim 2 & Paulo César Rodrigues Conti 1 Received: 27 April 2020 / Accepted: 6 November 2020 # Springer-Verlag GmbH Germany, part of Springer Nature 2020

Abstract Objective To study and estimate the impact of clinical, somatosensory, and psychosocial variables associated with the concomitant presence of temporomandibular joint (TMJ) pain in patients with TMJ clicking. Materials and methods Ninety-three individuals composed the sample: patients with painful TMJ clicking (n = 47) and patients with painless TMJ clicking (n = 46). Four categories of data were evaluated: clinical features (gender, maximal interincisal distance (MID), side of complaint, age); bruxism (sleep bruxism (SB), awake bruxism (AB)); somatosensory (mechanical pain threshold (MPT), wind-up ratio (WUR), pressure pain threshold (PPT), conditioned pain modulation (CPM)); and psychosocial (Pittsburgh Sleep Quality Index (PSQI), pain vigilance and awareness questionnaire (PVAQ), Pain Catastrophizing Scale (PCS), Tampa Scale for Kinesiophobia for Temporomandibular Disorders (TSK/TMD), Oral Behaviors (OBs)). Results Female gender, AB, WUR, CPM, PSQI, PCS, and OBs significantly (p < 0.05) increased the chance of the concomitant presence of TMJ pain in patients with TMJ clicking. On the other hand, MID, MPT, and PPT significantly (p < 0.05) decreased this chance. The other variables had no association. Conclusion It can be concluded that being a woman, having AB, hyperalgesia in WUR, less efficient CPM, poor sleep quality, pain catastrophizing, and harmful OBs significantly increased the chance of the concomitant presence of TMJ pain in patients with TMJ clicking. In the opposite, high figures of MID, MPT, and PPT decreased the chance. Clinical relevance Most patients with TMJ clicking usually postpone seeking treatment until the clicking truly disturbs or there is a concomitant presence of TMJ pain. Understanding the variables associated with this concomitance can be important in clinical practice. Keywords Temporomandibular joint . Temporomandibular joint disc . Clicking . Pain . Somatosensory function . Psychosocial profiles

Introduction * Rodrigo Lorenzi Poluha [email protected] Giancarlo De la Torre Canales [email protected] Leonardo Rigoldi Bonjardim [email protected] Paulo César Rodrigues Conti [email protected] 1

Bauru Orofacial Pain Group, Department of Prosthodontics, Bauru School of Dentistry, University of São Paulo, Al. Octávio Pinheiro Brisola, 9-75, Bauru 17012-901, Brazil

2

Bauru Orofacial Pain Group, Department of Biological Sciences, Bauru School of Dentistry, University of São Paulo, Al. Octávio Pinheiro Brisola, 9-75, Bauru 17012-901, Brazil

Temporomandibular disorders (TMD) are a group of musculoskeletal disorders that affect the stomatognathic system [1]. The most frequently reported signs and symptoms a